When to Hire a Workers’ Comp Lawyer

When to Hire a Workers’ Comp Lawyer
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If a workplace accident injures you, one of the first questions you may have is, “Do I need to hire a workers’ comp lawyer?” The answer to that question is, “Usually, yes.” In fact, it depends on the type and seriousness of your injury, whether you missed time from work, and several other factors.

In most states, workers’ compensation law does not allow an employee who is injured on the job to sue his/her employer for work-related injuries. Under workers’ comp law, workers can only file a workers’ compensation claim against their employer for a work injury.

In fact, employees receive workers’ compensation insurance provided by their employer’s insurance company. Moreover, most states require employers to carry that insurance protection.

Indeed, these benefits are available to an employee even if the employee’s own negligence caused his injury.

As a result, all the worker must do is show the injury occurred while he was working.

Since the workers’ compensation system is in place to help injured workers, many injured employees assume they don’t need a workers’ compensation attorney.

However, companies and employers may not want to pay out the full amount of compensation possible in every case. In their minds, to do so shrinks profits and makes shareholders unhappy.

In addition, there are often situations with a lack of clarity surrounding what caused the work-related injury to the worker. The employer and/or insurance company may claim an injury occurred outside of the workplace. Alternatively, they may claim the workers’ injury was caused by a pre-existing condition rather than a workplace incident.

Certainly, in these and other situations, a workers’ compensation attorney can protect your rights and work to ensure you get the compensation you are entitled to.


Depending on the nature of the workplace accident that injured you, you may need a workers’ comp attorney to make sure you get the comp award you deserve. You may want to hire a worker’s compensation attorney if any of the following apply to you:

You Have A Pre-Existing Condition

If you have any serious pre-existing health condition, it may be used as an excuse to deny or lower your compensation award. Insurance companies and employers may claim your injury is not related to a workplace accident because of the pre-existing injury.

However, a pre-existing condition does not disqualify you from receiving workers’ comp benefits.

Your Employer Denies the Injury/Accident Occurred at Work

Your workers’ compensation claim may be denied if your employer claims your injury did not happen at work or is due to your work duties. Consequently, a worker’s compensation attorney can clearly establish the link between your injury and your work.

Of course, without this proof, you may be denied the comp award.

Your Award Is Denied or Is Taking Too Long

Eighty percent of employees whose workers’ compensation benefits have been denied fail to appeal the denial. However, if your workers’ comp claims have been denied or you find your benefits are delayed, you can appeal or turn to other legal remedies. A workers’ compensation attorney can guide you through the claims process. In addition, she can get the medical documents that may help your appeal.

Your Workers’ Compensation Award Does Not Include All Your Medical Bills or Lost Wages

After you get an award, you may have concerns about the way your wage loss benefits are calculated. Incorrect calculations could leave you with fewer wage loss benefits than you should be getting. Alternatively, there may be an issue if all your medical bills are not covered. Therefore, you may need a workers’ comp lawyer to make sure all you get all your benefits.

Your Injury Is Permanent or Long-Term

If your injury is permanent or long-term, your medical costs and treatment will be considerable. In these cases, it’s more likely your employer or its insurance company may try to limit how much they will have to pay.

Notwithstanding that, if you have a permanent or serious injury and cannot work, your workers’ compensation attorney can get you the long-term benefits you deserve.

Your Doctor Recommends Treatment and the Insurance Company Won’t Pay for It

Unfortunately, this is a common practice when an injured worker’s recovery means rehabilitation visits that an insurance company thinks are unnecessary.

You Face Retaliation After Filing a Claim

If you file a workers’ compensation claim and your employer retaliates against you, you should speak to a workers’ compensation attorney immediately. This retaliation is unlawful. Indeed, it could take many forms, including reducing your hours, demoting you, or harassing you. Hiring an attorney can help you right the wrongs invoked through employer retaliation after a workplace injury.

Your Employer Does Not Have Workers’ Compensation Insurance

Most states require employers to have workers’ compensation coverage for all qualified workers. Typically, employers fulfill this insurance requirement through self-insurance or by getting workers’ comp insurance coverage.

If your employer has allowed the insurance to lapse or has never secured insurance for you as required by law, you may still qualify for benefits under the Uninsured Employer Guaranty Fund. An attorney can find out what options exist for you.

You Are Being Accused of Fraud

An employee who intentionally receives wages while also receiving total or partial disability benefits that exceed the permitted amount commits fraud. While workers’ compensation fraud is a real concern, you shouldn’t be denied benefits if you are legitimately injured.

Therefore, if your employer or their insurance company alleges you are trying to defraud the system, consult with an attorney.

You Plan to File for Social Security Disability Benefits

Those benefits, known as SSDI, may be reduced by workers comp benefits. A lawyer can structure your settlement to minimize or eliminate the offset.

You Are Eligible for Medicare or Will Become Eligible Within 30 Months

If you file a workers’ compensation claim and are Medicare-eligible, your settlement may be submitted to Medicare. In these cases, you may enter into a Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA).

A WCMSA designates part of a workers’ compensation settlement to cover future medical expenses for your workplace injury. Those funds must be used up before Medicare pays for your workplace injury treatments.

In fact, Medicare may deny some of your medical costs unless you proceed carefully. Of course, an attorney can work with you to ensure your future medical costs are covered.

Your Injury Is Hard to Quantify for a Monetary Award

Some injuries are very clear. For example, if you fell off a scaffold at a construction site and broke a leg, x-rays show the broken limb. Likewise, if you have surgery after an accident, there will be medical records detailing the procedure and medical treatment.

However, many other injuries are harder to prove. For instance, if your injury causes you severe mental trauma, how do you show it? Certainly, such trauma may prevent you from working. But how do you prove it?

Likewise, it can be difficult to quantify the effects of that trauma using medical tests.

Similarly, soft tissue injuries can be difficult to prove since they do not always show up on X-rays.

However, a workers’ compensation attorney can ensure you are evaluated by qualified specialists who can submit compelling medical evidence about your injury for your workers’ compensation case.


If a work-related accident injures you, you are entitled to workers’ compensation. But you may also have a separate personal injury claim against a third party who negligently injured you.

For instance, you may be a truck driver making a delivery for your company. If another driver negligently causes a motor vehicle accident that injures you, you can sue that driver for your injuries (and file a workers’ compensation claim).

Likewise, if a subcontractor on a construction site negligently injures you while operating heavy machinery, you may have a personal injury claim against that subcontractor.

In those instances, you will want a personal injury attorney to represent you (or a workers’ compensation attorney who also handles personal injury cases).

And unlike workers’ comp claims, you can also seek damages for pain and suffering. Claims for pain and suffering are not permitted under workers’ compensation law.


An experienced workers’ compensation attorney can act as your advocate and help you understand the best way to proceed with your case.

We will investigate the circumstances that led to your accident.

Also, we’ll explain your legal rights and your options under workers’ compensation law.

We’ll get you the workers’ compensation award to which you are entitled.

Contact our law firm at our Hammond office at (219) 200-2000 or online at for a free consultation.

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